Transcription

1 Patient Information: Low FODMAP Diet for Irritable Bowel Syndrome WHAT ARE FODMAPS? FODMAP is the acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, a group of short-chain carbohydrates and sugar alcohols (polyols). 1 These nutrients are ubiquitous in the diet. The key FODMAPs are: Oligosaccharides, such as fructans/fructo-oligosaccharides (found in grains and vegetables) and galactans/galacto-oligosaccharides (found in legumes) Disaccharides, such as lactose (found in milk) Monosaccharides, such as fructose (found in fruit) Polyols, such as sorbitol (found in sweetened products) WHAT EFFECT DO FODMAPS HAVE IN THE DIGESTIVE SYSTEM? Susceptible people can experience intestinal from ingestion of FODMAPs for a number of reasons. The carbohydrates are not well absorbed into the body and remain in the digestive tract for longer periods. FODMAPs draw water into the intestines, which can increase bowel motions and promote diarrhoea These carbohydrates can be metabolised by the bacteria that normally reside in the bowel, producing gas, bloating and wind. 2 To determine if FODMAPs might be contributing to your, the most effective strategy is to eliminate all FODMAP-containing foods and observe your. Following the elimination of all FODMAPs, the next step is to complete systematic rechallenge one-by-one of each FODMAP to help determine the tolerable doses and types of FODMAPs for you. It is not generally recommended that you follow a low FODMAP diet for life; restricting dietary intake of a wide array of foods should generally be avoided if possible to reduce the risk of nutrient deficiencies. FODMAPs are a normal part of the diet and have benefits for health, such as providing fibre and prebiotics for gastrointestinal health. HOW TO EAT A LOW FODMAP DIET ELIMINATION PHASE To trial the low FODMAP diet, all high-fodmap foods need to be eliminated from the diet for at least two weeks, until there has been a significant reduction in. Relevant should be ed and recorded (using the diary in Appendix A) on a daily basis, to track any benefits from the dietary program. Table 1 gives a detailed list of foods in each FODMAP category that should be avoided. Where quantities are given, these foods should be avoided only above the given dose. Many alternative foods can be consumed whilst following a low FODMAP diet. Table 2 provides a list of suitable foods which can be enjoyed. Metagenics Technical Team September

3 THE LOW FODMAP DIET - REINTRODUCTION PHASE The reintroduction phase may be commenced after two weeks in the elimination phase, when some significant resolution of has been achieved. The goal is to systematically reintroduce each FODMAP to determine the level of individual FODMAP consumption that can be comfortably tolerated. 8, 9 A five week program for the reintroduction phase is outlined in Table 3. Each week, one specific carbohydrate type is trialled, with a serving consumed on three separate days. Symptoms are ed (using the diary in Appendix A) for 48 hours after each dose to determine if there is a possible reaction to that carbohydrate. If you believe there is no reaction over the following 48 hours you can continue with the next dose of that carbohydrate. If you experience a worsening of following the reintroduction of a specific FODMAP, then it is recommend to discontinue trialling that FODMAP and wait until resolve. Once the have resolved you can move onto the next type of FODMAP to trial. All other FODMAP sources should continue to be avoided for the duration of the five week reintroduction phase, even if a particular FODMAP appears to be well tolerated from the rechallenge. Small doses of individual FODMAPs may have an additive effect which makes it difficult to determine the individual cause. Table 3. The reintroduction phase of the low FODMAP diet. 10 Week 1. Mannitol and sorbitol (polyols) Week 2. Lactose (di Week 3. Fructose (mono Week 4. Fructans (oligo Week 5. Galactans (oligo Monday Tuesday Wednesday Thursday Friday Saturday Sunday mushrooms, mushrooms, mushrooms, and and and CREATING YOUR INDIVIDUALISED LOW FODMAP DIET After the five week trial, it is recommended to integrate foods from all the FODMAP groups which were welltolerated into your normal diet, to determine your tolerance of the combination of FODMAPs. Symptoms should continue to be ed closely during the reintroduction. If there is a return of then it is recommended to eliminate those FODMAP groups again until resolve. The combination of FODMAPs should then be reintroduced at a lower dose. For the FODMAP types which aggravated, it is recommended you continue to avoid, or significantly restrict, foods containing these FODMAPs in your diet. Table 1 provides a list of the foods grouped by FODMAP type to be used as a reference for continued avoidance. Your practitioner may be able to assist to improve your tolerance of FODMAP containing foods over time. Metagenics Technical Team September

4 APPENDIX A DIET AND SYMPTOM DIARY Metagenics Technical Team September

FOOD INTOLERANCE, Management Plan by Dr. Sue Shepherd and Dr. Peter Gibson ALL ABOUT FOOD - Food allergy or food hypersensitivity are quite uncommon. These are reactions to a protein in the food and involve

The GFP Low FODMAP Diet Have you been diagnosed with IBS? Have you tried going on a gluten-free diet due to celiac disease or a gluten-sensitivity, but you re still having GI issues such as abdominal pain

High Eating Why is eating a high potassium diet important? is a mineral found naturally in many foods. It can help lower blood pressure and may lower the risk of heart disease and stroke. It is used in

On this list the low glycemic carbs that are carb dense and would therefore have a high glycemic load have an asterik *after them. Don t eat more than 1 serving per meal and for most people no more than

What is potassium? Kidney Disease and Potassium Potassium is a mineral found in food. Your muscles and nerves need potassium to work well. Your heart muscle needs potassium for a strong beat. Your kidneys

Anti-Inflammatory Diet The following is a list of foods that are anti-inflammatory in nature. These are examples of foods that you should try to increase in your daily diet to be of benefit. There is no

Female Fat Loss Formula Diet: This is the diet you will follow. There are no foods that are off limits, but rather foods that are emphasized and those that are minimized. Here are the general rules you

Food Sources of Fibre Information About Fibre Fibre includes all parts of plant foods that your body can't digest or absorb. Fibre is also known as roughage or bulk. Insoluble fibre helps promote regularity

Protein Values in Foods This document is used as reference material to support the Alternative Health Improvement Center s Newsletter article: Eat your Protein! Stay Healthy! located at http://ahicatlanta.com/articles/eat-your-protein-to-stay-healthy.html.

Making Pregnancy Meal Plans 3 steps to custom meal plans you can really use! For more detailed instructions as well as examples, read Making Pregnancy Meal Plans in 3 Simple Steps. Step 1 Create a daily

POTASSIUM Potassium is a mineral, which is found in all cells of the body and a certain level in the blood. Potassium helps to maintain fluid balance and normal muscle function. If your kidneys are unable

Dietary Management of Inflammatory Bowel Disease Crohn s disease and chronic ulcerative colitis are two diseases that are together classified as inflammatory bowel disease (IBD) and result in an inflammation

r Fibe An important part of a healthy diet is eating a variety of fiber-rich foods, including whole-grain breads and cereals, fruits and vegetables, beans and nuts. Fiber is an important part of your diet.

Nutrition for children with Type 1 Diabetes Food is essential for growth and good health in children and young people. Food also plays an important role in the control of diabetes. Food is made up of a

Male Active #phen375 www.phen375.com Below you'll find your new meal plans for success. Each of these meal plans have been specifically formatted with the precise number of calories, proteins, and carbohydrates

WHAT IS GLYCEMIC INDEX? Glycemic Index or GI Index is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels. It measures how much your blood

Ulcerative Colitis and Diet What is Ulcerative Colitis? Ulcerative Colitis is a condition that causes inflammation in the large intestine. The symptoms of ulcerative colitis depend on the severity of the

My Diabetic Meal Plan during Pregnancy When you have diabetes and are pregnant, you need to eat small meals and snacks throughout the day to help control your blood sugar. This also helps you get in enough

How do I manage my diabetes? Diabetes Eating Healthy It is important to control diabetes by living a healthy lifestyle. This includes: eating healthy remaining active watching your weight taking medication

Low Oxalate Diet Oxalate can be found in healthy plant foods. What can become confusing for some patients is that they have already been put on dietary restrictions because of some other medical conditions

These are general guidelines to help improve blood sugar levels. Talk to your dietitian about how they fit into your specific kidney diet. Foods are made up of protein, fat and carbohydrate. Protein (meat

Fiber An important part of a healthy diet is eating fiber-rich foods. This handout will explain what fiber is, where it s found, and how to increase the amount of fiber in your diet. What is fiber? Fiber

Food Groups for Low Potassium and Low Phosphorus Diets When you have kidney disease, you may need to follow a diet low in sodium, potassium and phosphorus. This diet is sometimes called a renal diet. You

United s Department of Agriculture National Agricultural Statistics Service Crop Values 2015 Summary February 2016 ISSN: 1949-0372 Contents s Included in the United s Marketing Year Average Price Estimates...

Eating After Your Ileostomy UHN Information for patients and families Read this booklet to learn: how you should eat and drink after your ileostomy surgery important tips to remember a list of foods that

What is the Glycemic Index (GI)? It is a method used to classify carbohydrate containing foods, according to the effect that they may have on blood sugar levels. It is claimed that the higher the GI number,

High-iron diet What is iron? Iron is a mineral found in every cell of the human body. Iron helps to carry oxygen from our lungs, around our bodies, to our brain and our muscles. This helps to keep us physically

Low Fructose Diet What is Fructose? Fructose is a sugar found naturally in three forms: free fructose, as a disaccharide in sucrose (table sugar) and as chains of fructose units called fructans. Dietary

What is the Glycemic Index? The glycemic index (GI) is a ranking of foods based on their potential to raise blood glucose. Why is the level of blood glucose important in regards to eczema? A high blood

Eating Well on a Low Potassium Diet- Getting Started Potassium is a mineral found in most foods and some beverages. Potassium helps your muscles work properly and your heart to beat normally. Your kidneys

PART 5 INTRO TO EATING WITH DIABETES When you have diabetes be careful about what you eat to help you control your blood sugar. Foods are in three main groups: Carbohydrates (Carbs) Higher Carbohydrates

Dietary Management of Constipation What is constipation? Constipation is when you have infrequent bowel movements (less than 3 times per week). Symptoms of constipation can include: Straining or difficulty

Carb factors for various foods Using a digital gram scale and carb factors to calculate your carbohydrate What is a carb factor? A carb factor represents the amount of carbohydrate found in 1 gram of a

Healthy Eating for Diabetes What is diabetes and why is it important to manage it? Diabetes occurs when there is too much glucose in the blood. Learning how to manage your diabetes will help you feel better

Glycemic Index (GI) Food Chart Below you'll find the Glycemic Index (GI) of most common foods. As stated in my original video, your goal should be to eat low and medium GI foods, while staying away from

Exchange Content Elements Check the following lists to find your favorite foods. However, if you can t find an item, you can use the information below to determine the exchange value. It provides the elements

Super Green Tea Diet Insert WELCOME TO A NEW YOU As the first choice among weight loss and fitness enthusiasts, Super Green Tea Diet is a popular alternative to many of the high-protein, low-carbohydrate

GHPI0811_08_07 Author: Continence Review due: August 2010 Patient Information for the Gloucestershire Health Community Dietary Fibre Notes Introduction Fibre is an extremely important component of a balanced,

From: www.weightlossforall.com Food Calories List The food calories list is a table of everyday foods listing their calorie content per average portion. The food calories list also gives the calorie content

Information About Fibre Food Sources of Fibre Fibre includes all parts of plant foods that your body can't digest or absorb. Fibre is also known as roughage or bulk. Insoluble fibre helps promote regularity

Winter The KidneyKorner for people on dialysis from the makers of with Carb Steady What s Inside: The Scoop on Potassium What is Potassium?... Page 2 What is the Role of Our Kidneys?... Page 2 High and

What is fibre? Dietary Fibre is the edible part of plants that escapes digestion in the small intestine, passing through to the large intestine where it is mostly broken down by bacteria. Different types

Diet plan: What foods should I eat on a renal diet? Information for patients, relatives and carers The information in this leaflet includes a diet that is low potassium, phosphate and salt. It also includes

High Fiber Diet What is fiber? Fiber is a type of carbohydrate that our body is not able to break down. Foods that are highest in fiber are fruits, vegetables, and unprocessed grains. Why does my child

Blood Blood Sugar Sugar Support Program Program Blood Sugar Support Program Reshape Your Life IN10 Days ar www.standardprocess.com/10-day-programs 1 2 BLOOD SUGAR Blood Blood Sugar Sugar Support Program

April 2015 Maryland Grown: HOW WHAT WE GROW COMPARES WITH WHAT WE EAT INTRODUCTION The USDA Census of Agriculture provides a wealth of data on what, where and how much land is farmed across the country.

NUTRITION E- Book San Francisco California, UNITED STATES OVERVIEW Type 2 diabetes, your body either resists the effects of insulin a hormone that regulates the movement of sugar into your cells or doesn't

Diverticulitis Diverticulosis is a condition in which the inner lining layer of the large intestine or colon bulges out (herniates) through the outer, muscular layer. These outpouchings are called diverticula.

This one-week meal plan is based on Canada s Food Guide recommended servings for a senior woman. Senior men should add one Food Guide Serving of grain products a day. (For example, a senior man could add

Colorful Nutritious Lunches that Inspire and Support the Child at School 1 CREATING A BALANCED, NUTRITIONAL FOOD PLATE 2 Austin Montessori School recognizes the importance of a healthy lunch for children.

Snacks and Packed Lunches for 1-4 year olds Snacks and Packed Lunches for 1-4 year olds Published by First Steps Nutrition Trust, 2014 The text of this resource, and the photos, can be reproduced in other

10-Day Detox Program Evolving research suggests that the cause of many health problems may be associated with prolonged exposure to various toxic agents in our environment. Some of your health challenges

Healthy eating for toddlers Toddlerhood is a time where children learn about new foods and where life long eating habits are often established. To help children grow up to be healthy adults, it is important